What is EMDR and what happens during a session?
EMDR is a psychological treatment in which you recall a distressing memory and simultaneously perform another task, often with eye movements. The memory does not disappear, but can become less sharp and disruptive.
EMDR is more than following a finger
The memory
You focus on a selected image or moment and on what it evokes: tension, physical reactions or a negative meaning.
The double task
For example, while the reminder is active, you follow a moving point. Other tasks can be used if more appropriate.
The goal
Reducing the emotional charge and liveliness and strengthening a more helpful meaning. What happened is not erased.
What happens in the core?
The precise implementation varies. This diagram shows the main line, not a protocol to follow yourself.
The strongest evidence is for PTSD in adults
The name EMDR is used for more complaints, but that does not automatically make the evidentiary value equal.
Well substantiated: PTSD
The Dutch multidisciplinary guideline from 2025 recommends EMDR as a psychotherapeutic treatment for adults with PTSD. NICE offers EMDR to certain adults with PTSD and the WHO mentions EMDR in its recommendations.
More limited or complaint-oriented
EMDR is also being investigated or applied for other complaints and for unpleasant memories without full-blown PTSD. Research size, quality and place in guidelines differ per condition. Ask what the proposal is based on in your situation.
No blanket promise
EMDR has not been proven as a universal treatment for every anxiety, depression, physical complaint or unexplained complaint. A casual application is not the same as a guideline treatment for PTSD.
A session has a purpose, a chosen memory and fixed evaluation moments
The precise implementation varies per protocol, age and request for assistance. This is a recognition card, not an instruction to carry out yourself.
Prepare and explain
You discuss the request for help, history, safety and what you can expect. You also agree on how to indicate tension and what can happen between sessions.
Choose a target reminder
Together you determine which memory or image is to be treated and which negative meaning arises, for example “I am powerless”.
Determine tension and image
The practitioner asks about the current tension, physical reaction and liveliness. This gives a starting point and helps track the change.
Remembering plus double duty
You hold the memory briefly in mind while performing a task, often involving rapid eye movements. After a series, the practitioner asks what comes up; then the process continues.
Reassess
The tension and meaning are revisited. When appropriate, a more positive, credible meaning is linked to the memory.
Wrapping up and looking ahead
You discuss your reaction to the session, what you can notice and what to do next. Not every goal is completed at the end of one session.
It can be intense, without you experiencing the event again
During a session, tension, sadness, shame, anger, physical sensations or unexpected associations may arise. Afterward, some people report fatigue, dreams, or new memories. Others don't notice anything special.
Discuss in advance how a session will be completed, what you will do in the event of significant disruption and when you will contact us. If you don't feel safe, get lost or can't keep up with the pace, say so as early as possible.
"You don't have to be aggressive. The pace and workload should remain open for discussion."
The working memory explanation is plausible, but not the whole answer
What research supports
A stressful memory and a double task simultaneously require limited mental capacity. Experimental research shows that memories can become less vivid and emotional on average. This supports the working memory model.
Which is not definitively established
EMDR is a complete treatment protocol with more components than eye movements. Research has not proven that one brain process or one specific component explains all treatment outcomes. Stories about “synchronizing both hemispheres” go beyond the certainty of the evidence.
A guideline bandwidth is not a personal prediction
NICE typically describes 8 to 12 sessions for adults with PTSD, with more sessions if clinically needed, for example for multiple traumas. In practice, the duration can be shorter or longer depending on the request for help, the number of goal memories, additional problems, session length and treatment intensity.
Ask in advance when progress will be evaluated, with what complaints and job goals, and what the plan is if sufficient improvement is not made. Just “trying a few more sessions” is not a complete evaluation.
Questions that make a proposal concrete
Is it established PTSD, specific memories or an application with less evidence?
Also ask how supervision and expertise are arranged.
Discuss priority, connection with complaints and what is not addressed.
Ask about measurements, daily functioning and an evaluation date.
Have the pace, signals and contact options made concrete in advance.
There are several recommended trauma-oriented treatments for PTSD; preference and previous experience count.
Frequently asked questions about EMDR
Do you have to say everything out loud with EMDR?
Does EMDR only work through eye movements?
Can EMDR temporarily make complaints stronger?
Reliable explanation and help
- Multidisciplinary PTSD guideline 2025 - current Dutch recommendations and evidence assessment for psychotherapy in adults with PTSD, including EMDR.
- NICE PTSD guideline - recommendations on complex needs, trauma-oriented psychotherapy, EMDR and medication in adults.
- WHO: Psychological treatment of PTSD - international recommendation from 2023 that includes EMDR as a possible psychological intervention for adults with PTSD.
- Systematic review of the working memory model - research into the reduction of vividness and emotionality when remembering is combined with a dual task.